| Learning Objective #1: Identify and define aversive racism and the probable role it plays in health disparities | |||
| Learning Objective #2: Propose strategies to intervene in the production of social biases in health services |
Partnerships between primary care clinical preceptors and schools of nursing are essential to the educational preparation of nurse practitioners. Nursing educators are being challenged to design curriculum around concepts of behavioral change and care of diverse populations in addition to essential clinical and prevention skills. Purposive focus groups of primary care nurse practitioners and physicians were held in urban and rural sites as an example of planned outreach to the community of preceptor practitioners. Community-based partners were asked about their needs with students, the barriers they face, what would facilitate successful university-preceptor-student relationships, and their experiences with diverse populations. Focus groups were also held with students and nurse practitioner faculty. The themes the groups both identify and exclude offer valuable lessons to those interested in curriculum reform and in building more sensitive partnerships between clinical preceptors and academic faculty. Commonly, faculty, students, and clinical preceptors found it difficult to identify or deal with situations of cultural conflict or social bias. Despite recent findings of widespread health disparities, a sociocultural audit of curriculum revealed that structural notions of culture as beliefs may be addressed, but that social biases and inequalities in care receive relatively little attention, especially those concerned with race/ethnicity. Participants referred to structural barriers within clinical practice and academic programs that constrained practitioners' care to patients, but not habits of practice. The lack of recognition of racial disparities and cultural competence in health care suggests that advanced practice nursing’s focus on clinical skills requires more specific strategies to evaluate and address inequitable care. A variety of interventions will be suggested to systematically map curriculum to insure inclusion of concepts and skills related to social equity in care and cultural competence in education and to monitor social equity in clinical practice.
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